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Alternatively: "I wrote it down: I got the first injection on December 30th" / "You have to keep in mind that this virus is treacherous" / "We are poking around in the fog a little"
According to the DIVI intensive care register, almost 17 percent of the intensive care beds in Germany are still free, of the 22,462 intensive care beds, 5491 are occupied by Covid 19 patients.
Of these, 3099 have to be ventilated.
The number of intensive care patients remains high, the number of Covid deaths is increasing.
Questions to intensive care physician Stefan Kluge from the University Medical Center Eppendorf (UKE) in Hamburg.
WORLD:
During our last phone call just before Christmas, you were a little worried because you feared that the increased number of holiday contacts would lead to many more Covid admissions in the clinics.
How is it currently?
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Stefan Kluge:
We currently have 23 Covid patients in the intensive care unit, eleven of them are supplied with oxygen via an ECMO, the extracorporeal membrane oxygenation.
We have also had 27 Covid intensive care patients, the numbers fluctuate.
WORLD:
So no holiday effect?
Kluge:
No, but it could still come.
Christmas was just two weeks ago.
And as far as the reports on the number of infections are concerned: The numbers should really only be treated with great caution at the moment - there are still late reports, less testing has been carried out.
One day 20,000 new infections are reported, the next 10,000, unfortunately the numbers cannot currently be trusted.
We poke a little in the fog.
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WELT:
The situation has been tense for weeks, there are many patients, important operations have to be postponed, and nurses and doctors are also falling ill.
How do you keep staff motivated?
Kluge:
The stress is high, but if you decide to work in the intensive care unit, you are also somewhat prepared for it.
Professionals work here.
But it is undoubtedly an extraordinary situation.
So we try to talk to each other a lot.
There is also the option of psychological support for the clinic staff.
We hold virtual station meetings in which we also talk about the loads.
I also went to the intensive care unit on New Year's Eve to signal that we are taking the stress very seriously.
That I am not partying at home while others are working hard.
WORLD:
Have you personally reached your limits?
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Kluge:
Well, as an intensive care physician, I'm used to very dynamic and critical situations.
So my pain threshold is high.
But it is a lot of organizational effort if, for example, an employee has tested positive, the contact tracing starts and the reorganization of services.
Fortunately, we have never reached the limit so far.
But the collateral damage in Germany caused by postponing operations and treatments - that will continue to occupy us a lot.
WELT:
Now there is finally good news: The vaccinations have started in Germany - there has just been EU approval for the second vaccine.
Are you vaccinated?
Kluge:
Yes, I made a note of it: I got the first injection on December 30th.
We had received more vaccine from the agency than expected.
I got a dose of it.
Intensive care physician Stefan Kluge is vaccinated
Source: Ronald Frommann
WORLD:
Did you have any side effects?
Kluge:
Not worth mentioning, slight pain at the injection site.
WORLD:
You always hear that the willingness to vaccinate in clinics and nursing homes is so low.
How is it in your reality at the university hospital?
Kluge:
We are probably not 100% ready to vaccinate here either, there will never be.
A survey by the German Society for Internal Intensive Care Medicine and Emergency Medicine before Christmas showed that only around 50 percent of nurses want to be vaccinated.
But I don't see that with us at the moment.
In my direct work environment, everyone is very motivated to get vaccinated.
In the UKE we completely inoculated all cans that have been delivered so far in the first two weeks.
The demand for vaccination appointments is high.
Our company medical service vaccinates with us.
We have set up a vaccination station in an adjoining building of the university hospital.
On the day I was vaccinated, there were doses left over due to the unexpectedly higher delivery volume.
The vaccine is delivered thawed and needs to be injected quickly.
I had informed the Covid intensive care unit and was happy that more nurses had been vaccinated in the next hour.
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WORLD:
How long will it be before all employees are vaccinated?
Kluge:
That depends on the supplies, we are dependent on the delivery from the health authority in Hamburg.
But we currently have three intensive care wards and three normal wards where Covid patients are treated.
All doctors, nurses, physiotherapists and cleaners who work there must be vaccinated twice.
Of course it takes time.
We have around 13,600 employees at UKE.
WORLD:
But what would you do if a doctor or a nurse on the Covid ward didn't get vaccinated?
Kluge:
Well, that would be unfavorable - but more for your own health.
The patients are already Sars-CoV-2-positive, that's not a problem for them.
It is of course more problematic if employees in high-risk areas of hospitals or in old people's homes do not get vaccinated.
You endanger the elderly.
I believe, however, that in two or three weeks the willingness to be vaccinated will increase if everyone can see that the vaccination does not cause any serious side effects.
And if you know someone who has been vaccinated, the willingness to be vaccinated is higher.
But I don't know whether more than 60 percent of society will be vaccinated.
WORLD: The
Moderna vaccine has just been approved for the EU.
There are discussions about postponing the second dose a little or even vaccinating two different active substances because of the great shortage of vaccines.
How do you think about it at the UKE?
Kluge:
We discussed it, Marylyn Addo, our infectiologist and vaccination expert at UKE, was also there.
We will stick to the current approval, anything else at the clinic would be too unsafe for us.
The approval studies followed a fixed protocol, and the active substance and effectiveness have only been tested for this vaccination schedule.
WORLD:
Let's come back to the utilization of the clinics.
There are experts who say that we can manage 25,000 new infections per day in Germany well.
The clinics would then still be full - but you said yourself: You have not yet reached the absolute limit.
Kluge:
Yes, luckily it is, and luckily triage has not been an issue either.
But to focus on the new infections is not enough.
If 30,000 20-year-olds become infected every day, then maybe that is doable.
But if it were 30,000 70-year-olds, then of course it would look very different.
The Hamburg health authority has just published statistics: According to them, the risk of death for 60 to 69 year olds is 1.6 percent.
For the 70 to 79 year olds it is 8.7 percent and for the over 80 year olds it even rises to 15 percent.
That is why it is so important that the elderly, but also the nursing staff in homes, protect themselves through the vaccination.
We have seen that without vaccination it is not possible to completely shield the elderly from the virus.
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WORLD:
There are many people - unfortunately also caregivers - who are afraid of the side effects and possible consequential damage of the vaccination.
Kluge:
Only education helps.
The vaccines have been tested and approved.
The problem is that 20 percent of those infected have no symptoms whatsoever.
People don't notice anything, they have no runny nose, no headaches, no sore throats.
We have already seen this in the clinic: Doctors or nurses who felt good, who came to work in perfect health.
Only one test showed they were infected.
The risk of asymptomatic transmission is very high with high incidence rates.
WORLD:
As long as not everyone is vaccinated, do tests have to be carried out?
Kluge:
Yes.
For example, we had a patient who came to us for routine surgery and presented a day-old negative PCR test.
One day later, however, it was already positive.
And I know of a case where an infected person sat next to another in the waiting room for only ten minutes - and during that time the infection happened.
Tests can't do everything.
But they help to significantly reduce the risk.
The new requirement of the health authority stipulates that hospital employees in high-risk areas are tested for Sars-CoV-2 twice a week.
We are already doing this in the intensive care clinic.
You just have to keep reminding yourself that this virus is treacherous and that we are still not allowed to feel safe.